FAIR CREDIT REPORTING ACT DISCLOSURE STATEMENT
In accordance with the provisions of Section 604(b)(2)(A) of the
Fair Credit Reporting Act, Public Law 91-508, as amended by the
Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter I,
of Public Law 104-208), you are being informed that reports verifying
your previous employment, previous drug and alcohol test results, and
your driving record may be obtained on you for employment purposes.
These reports are required by Sections 382.413, 391.23, and 391.25 of
the Federal Motor Carrier Safety Regulations.
REQUEST FOR CHECK OF DRIVING RECORD
I hereby authorize you to release my Motor Vehicle Record (MVR) to
RST, Inc. for the purposes of investigation as required by Section
391.23 of the Federal Motor Carrier Safety Regulations. You are
released from any and all liability, which may result from furnishing
such Information.
I authorize RST INC ("Prospective Employer") to access the FMCSA
Pre-Employement Screening Program(PSP) system to seek information
regarding my commercial driving safety record and information regarding
my safety inspection history. I understand that I am consenting to the
release of safety performance information including crash data from the
previous five (5) years and inspection history from the previous three
(3) years. I understand and acknowledge that this release of
information may assist the Prospective Employer to make a determination
regarding my suitability as an employee.